Hormonal Contraceptive Side Effects and Nonhormonal Alternatives on TikTok: A Content Analysis

Online Misleading Information About Women's Reproductive Health: A Narrative Review

Misinformation about reproductive health threatens to harm health outcomes, compromise medical trust, and enable misinformed policy restrictions. In recent years, reproductive health misinformation has proliferated online due to ideological campaigns and limited content moderation for reproductive health topics. Developing evidence-based practices to counter reproductive health misinformation requires an understanding of the content that women are exposed to online, which is currently lacking. This review sought to identify common claims and narratives about reproductive health on social media and the internet that could easily mislead. We performed a narrative review of articles about online reproductive health misinformation, from which we extracted misleading claims and narratives. We conducted a qualitative content analysis to describe the ways in which the claims and narratives could be misleading. We found that potentially misleading claims and narratives about reproductive topics relating to contraception and abortion, fertility, chronic disease, breast cancer, maternal health, and vaccines abound across social media platforms and websites, with 112 identified in total. One-third of this content could mislead by claiming that evidence-based interventions were associated with unattributed risks. Twenty-three percent made medical recommendations that do not align with professional guidelines. Fourteen percent promoted alternative medicine. Smaller numbers of claims and narratives exaggerated risks of medical interventions, discouraged evidence-based interventions, directly undermined medical trust, and proposed inaccurate biological mechanisms. Healthcare professionals can proactively promote evidence-based medical decision-making by increasing their awareness of prominent misleading claims and narratives.

Sync or Swim: Navigating the Tides of Menstrual Cycle Messaging on TikTok

OBJECTIVE

To understand messaging about cycle syncing on TikTok, a trend that involves harmonizing daily activities and self-care rituals with various stages of the menstrual cycle.

METHODS

We conducted a quantitative content analysis of TikTok videos (N = 100). In January 2023, we collected TikTok videos from content creators using the hashtag #cyclesyncing.

RESULTS

About one-third of creators provided credentials. However, very few mentioned scientific evidence. More than half of the creators recommended aligning diet and exercise with the four menstrual cycle phases. Creators specifically recommended diets and exercises for each menstrual cycle phase.

CONCLUSION

Cycle syncing content on TikTok oversimplifies a complex literature involving tailoring diet and exercise to the menstrual cycle. Our findings also have implications for previous research pointing to negative discourse about hormonal contraception on social media and problematic messaging about women's reproductive health. More expert voices surrounding women's reproductive health are needed in the evolving social media landscape.

"Stop Gaslighting Your Patients": A Quantitative and Qualitative Analysis of User Experiences of IUDs on TikTok

STUDY OBJECTIVE

TikTok is a social media platform where patients can access and share information about intrauterine devices (IUDs). The primary objective of this study was to identify prominent themes of creators' experiences with IUDs on TikTok.

METHODS

We conducted a quantitative and qualitative assessment of eligible videos that appeared when searching for "IUD" on the TikTok platform between July 2019 and August 2022. Eligible videos contained content relevant to IUDs and were spoken and/or written in English.

RESULTS

Of the 354 videos that met inclusion criteria, the majority were created by users without healthcare expertise (77%) and mentioned personal experiences with IUDs (68%). However, videos that were educational (27%) or created by users with healthcare expertise (23%) averaged more likes and views than other video types. Common content areas included IUD insertion (45%), side effects (31%), and removal (25%). Perceived gaps in knowledge about the insertion procedure and feeling that providers did not adequately prepare patients for the procedure contributed to dissatisfaction with IUD insertion and motivated creators to share their experiences on TikTok. Video creators often relied on information that they found on TikTok to educate themselves about the IUD insertion process and expressed frustration at unacceptable levels of pain during insertion.

CONCLUSION

Healthcare providers should be aware that adolescent patients who use TikTok have likely seen videos depicting negative experiences with IUDs and be prepared to address patients' concerns, particularly regarding IUD insertion. Additionally, healthcare providers may use TikTok to educate users about IUDs.

A roadmap to reduce the incidence and mortality of breast cancer by rethinking our approach to women's health

Despite progress, breast cancer remains the most feared disease among women. In the USA alone, the incidence is now almost 300,000 new cancers per year, a rate that has nearly doubled in the last 30 years. Most women survive, but over 40,000 women a year still die of their disease [99]. It is the most diagnosed cancer among women and the second leading cause of cancer death. Important disparities exist in breast cancer outcomes among African American women, where women die of breast cancer at higher rates, are diagnosed younger, and at a more advanced stage. We are proposing a radical shift in our thinking about breast cancer prevention with an aspiration to dramatically lower breast cancer incidence. Most breast cancers are driven by steroid hormones. Throughout the life course, women are offered an array of hormonal treatments for menstrual cycle control, family planning, in vitro fertilization, postpartum weaning, and menopausal symptom management. There are mixed data on the extent to which each of these may contribute to increased or decreased risk for breast cancer. These endocrine manipulations could represent a great opportunity to potentially reduce breast cancer incidence and improve quality of life for survivors. To date, they have not been designed to explicitly reduce breast cancer risk. A new holistic approach will require scientists, drug developers, breast oncologists, obstetricians, gynecologists, endocrinologists, radiologists, and family medicine/internists to work together toward the common goal of reducing breast cancer risk while addressing other critical issues in women's health.

Disseminating Premenstrual Dysphoric Disorder Information on TikTok: A Content Analysis

Premenstrual dysphoric disorder (PMDD) is characterized as an extreme form of premenstrual syndrome (PMS) in which a combination of severe mood, somatic, and cognitive symptoms present one to two weeks prior to the onset of menstruation. As people increasingly turn to social media, specifically TikTok, to gain information about health-related topics and information, discourse about this taboo chronic condition has increased. Sensitized by concepts from the theory of communicative disenfranchisement (TCD), our two-pronged methodological approach includes a content analysis of TikTok videos (N = 97) that discuss PMDD symptomology, treatment, and a thematic analysis of disenfranchising talk associated with PMDD. We identify TikTok as a meaningful communicative mechanism for health information-exchange, particularly for communication about contested illness. Practical and theoretical implications for applying TCD in mediated contexts, as well as engaging with social media as a means for health communication are discussed.

Cycle Syncing and TikTok's Digital Landscape: A Reasoned Action Elicitation Through a Critical Feminist Lens

Cycle syncing is a menstrual health trend on TikTok that involves aligning exercise and diet with the four menstrual cycle phases. Cycle syncing is part of the conversation on social media about women's reproductive health. However, clinical research on the effects of cycle syncing is inconclusive, and there is the potential that this trend could further perpetuate misinformation and gender stereotypes. Research suggests that social media can affect health behaviors, highlighting the need to understand if women intend to participate in cycle syncing. Guided by the Reasoned Action Approach, this study used focus groups (n = 39) to examine young women's attitudes, normative beliefs, and control beliefs about participating in cycle syncing, and critical feminist theory to sensitize resulting themes. Results suggest that normative beliefs emphasize support for the behavior among women, yet participants suggest that men would not support this behavior. Additionally, positive beliefs about cycle syncing content sourced from inconclusive scientific literature underscores concerns regarding the potential dissemination of misinformation in women's health practices on social media. Findings also fit into a larger discussion about "hormonophobia" and contraception on social media. Theoretical implications for mixed methods research and future directions are discussed.

The Effect of Social Media Influencer Warranting Cues on Intentions to Use Non-Hormonal Contraception

Young women increasingly get sexual health information from social media influencers, who use persuasive communication and can alter attitudes, intentions, and behaviors. Contraception is a commonly discussed health topic among influencers on social media. Previous research suggests that influencers negatively frame and encourage the discontinuation of hormonal contraception. At the same time, influencers also encourage the uptake of less effective non-hormonal options, such as fertility awareness-based methods. Though descriptive content analysis work details these patterns in influencer contraceptive messaging, there is no experimental research that explains message effects. The purpose of this study was to experimentally test the effect of influencer contraceptive-related messaging on behavioral health intentions. This study introduces warranting theory as a potentially valuable model for explaining online health communication message effects. Specifically, this study tested the effect of influencer messages containing sponsorship and medical disclaimers on intentions to use non-hormonal contraception. U.S. females (n = 296) ranging in age from 18-29 years old participated in a survey. Findings suggest that the interaction led to decreased intentions to use non-hormonal contraception. However, findings did not support a relationship between influencer messaging and impressions, which highlights potential boundary conditions for warranting theory and high-risk health behaviors. Additionally, there was a positive relationship between perceived trustworthiness and expertise of the influencer and intention to use non-hormonal contraception. Future research should test influencer messaging using real social media content and consider the effect of parasocial relationships. Practical implications highlight the need for comprehensive contraceptive counseling.

Leveraging web search data in Germany to identify unmet needs of contraceptives on a population-based level: A longitudinal retrospective study

BACKGROUND

There are a variety of possible contraceptives available. While medical advice is an important resource for selecting the individual contraceptive, previous research has shown that the Internet has become an increasingly important source of health care information.

OBJECTIVES

This study aims to identify key trends in contraception-related web searches in Germany and thus allows conclusions about preferences and unmet needs with regard to pregnancy prevention.

DESIGN

Longitudinal retrospective study.

METHODS

Google Ads Keyword Planner was used to identify contraception-related keywords and their search volume in Germany and all federal states between 2018 and 2021. The keywords were categorized based on gender, hormonal/non-hormonal, and different contraceptive methods. Search volume and categories were analyzed for temporal trends, regional differences, and underlying socioeconomic variables.

RESULTS

The 1481 contraception-related keywords corresponded to 15,081,760 searches. In total, a 56% increase in searches/100,000 inhabitants was observed. Highest mean search volume was observed in categories "woman," "woman/non-hormonal" and "woman/non-hormonal/barrier," respectively, and in the federal state Hamburg, while the lowest was seen in North Rhine-Westphalia.

CONCLUSION

The increase in search volume reflects a high interest in contraception, particularly in non-hormonal female methods. This stands in contrast to the limited number of effective non-hormonal contraceptives available and points to an unmet need. In addition, the low search volume for male contraceptives demonstrates gender-specific responsibilities regarding family planning in German society.